Industrial Field of Utilization
[0001] The present invention relates to pharmaceutical composition for viral diseases which
comprises an angiotensin II antagonist compound as an active ingredient.
Prior Art
[0002] Virus vaccines are chiefly used in the prevention of viral diseases but each vaccine
is specific and effective only for the corresponding virus. While there exist many
kinds of viruses, vaccines commercially available today are limited in kind. Furthermore,
each virus has many mutants and it is often the case that a vaccine is not effective
for all strains of the same virus. It is also a very difficult task to develop vaccines
with low risks of side effects.
[0003] Meanwhile, a variety of antiviral drugs (aciclovir, ganciclovir, Ala-A, etc.) have
been developed and clinically in use but they are effective only for very limited
types of viral infections and no drug is available that is effective for a variety
of viral diseases. Moreover, the administration of such antiviral drugs may entail
severe adverse reactions prohibiting clinical application. In recent years, interferons
have come to be used in the treatment of some diseases inclusive of viral hepatitis
but side effects inclusive of fever have been reported with high frequencies. Moreover,
while interferons do actually inhibit the proliferation of viruses, there is no report
suggesting that they directly protect the cells from damages. Gamma-globulin is prevalently
used in the treatment of viral diseases but clinical responses are not necessarily
constant and definite.
Problems that the Invention is to Solve
[0004] Viruses vary a great deal as mentioned above and it is difficult to institute therapies
specific to the respective viruses. Therefore, it is an objective of paramount importance
to prevent or ameliorate cellular damages in various organs which occur in a variety
of viral diseases. It is generally acknowledged that the cell injury in viral diseases
includes not only direct damages inflicted by the proliferation of viruses but is
associated with various immunologic reactions elicited by infection with viruses.
The present invention has for its object to provide a prophylactic/therapeutic regimen
for viral diseases which is directed to the prevention and treatment of cell injuries
in various organs regardless of the type of virus involved.
Summary of the Invention
[0005] Under the circumstances the inventor of the present invention explored into the domain
of prophylactic/therapeutic treatment of viral diseases and found surprisingly that
the use of compounds having angiotensin II antagonistic activity results in accomplishment
of the above-mentioned object and have brought the present invention into being.
[0006] Therefore, the present invention provides a prophylactic/therapeutic composition
for viral diseases comprising an angiotensin II antagonist compound as an active ingredient.
Detailed Explanation of the Invention
[0007] An angiotensin II antagonist compound used in the present invention includes a compound
of the following formula (I).

wherein the ring W represents a nitrogen-containing heterocyclic residue which may
be substituted: R³ represents a group capable of forming or transformable to an anion;
X signifies that the phenylene and phenyl groups are coupled either directly or indirectly
through a spacer comprising a chain of not more than 2 atoms; n represents a whole
number of 1 or 2, or a salt thereof.
[0008] The salt mentioned above is a pharmacologically acceptable salt, thus including salts
with inorganic bases, salts with organic bases, salts with inorganic acids, salts
with organic acids and salts with basic or acidic amino acids. The preferred salts
with inorganic bases are salts with alkali metals such as the sodium, potassium, etc.,
salts with alkaline earth metals such as calcium, magnesium, etc., aluminum salt and
ammonium salt. The preferred salts with organic bases are salts with trimethylamine,
triethylamine, pyridine, picoline, ethanolamine, diethanolamine, triethanolamine,
dicyclohexylamine, N,N'-dibenzylethylenediamine and so on. The preferred salts with
inorganic acids are salts with hydrochloric acid, hydrobromic acid, nitric acid, sulfuric
acid, phosphoric acid and so on. The preferred salts with organic acids are salts
with formic acid, acetic acid, trifluoroacetic acid, fumaric acid, oxalic acid, tartaric
acid, maleic acid, citric acid, succinic acid, malic acid, methanesulfonic acid, benzenesulfonic
acid, p-toluenesulfonic acid and so on. The preferred salts with basic amino acids
are salts with arginine, lysine, ornithine and so on. The preferred salts with acidic
amino acids are salts with aspartic acid, glutamic acid and so on.
[0009] Referring to the above formula (I), the group R³ which is capable of forming an anion
(a group having a hydrogen atom which can be released as a proton) or transformable
to an anion is a 5- through 7-membered (preferably 5- or 6-membered) monocyclic heterocyclic
residue containing one or more hetero-atoms of N, S and/or O or a group capable of
biotransformation to such a group. Examples are

The bond between the group R³ and the phenyl group to which it is attached is not
limited to the carbon-carbon bond shown above but may be a bond formed through one
of plural nitrogen atoms that exist when g in the above formula is -NH-, for instance.
[0010] The following are examples:
When R³ is

there may be mentioned

As other examples of R³ which bind through one of nitrogen atoms, there may be
mentioned

[0011] Wherein g is -CH₂-, -NR⁵-, oxygen atom or

wherein >=Z, >=Z' and >=Z'' each represents a carbonyl group, a thiocarbonyl group
or a sulfur atom which may be oxidized (e.g. S, S(O), S(O₂), etc.) and among others
there are preferably mentioned carbonyl or thiocarbonyl, more desirably carbonyl;
m represents a whole number of 0, 1 or 2; R⁵ represents a hydrogen atom or a lower
alkyl group which may be substituted.
[0012] The heterocyclic residue mentioned above is preferably a residue having both a proton-donating
group, e.g. -NH or -OH, and a proton-accepting group, e.g. carbonyl, thiocarbonyl
or sulfinyl, such as the residue of an oxadiazolone ring, oxadiazolothione ring or
thiadiazolone ring, for instance. The heterocyclic residue R³ may also be a group
such that a cyclic substituent group is condensed to the heterocycle to form a fused
ring structure, although R³ is preferably a 5- or 6-membered ring residue and more
desirably a 5-membered ring residue. Moreover, these groups may be protected by lower
alkyl groups which may be substituted or acyl groups. Thus, any group that is chemically
capable of forming an anion or transformable to an anion under biological or physiological
conditions (e.g. by biological transformation such as oxidation, reduction or hydrolysis
by physiological enzymes) can be employed.
[0013] R³ is preferably a group of the formula

wherein i represents -O- or -S-; j represents >=O, >=S or >=S(O)
m; m is as defined hereinbefore. There are preferably mentioned 2,5-dihydro-5-oxo-1,2,4-oxadiazol-3-yl,
2,5-dihydro-5-thioxo-1,2,4-oxadiazol-3-yl and 2,5-dihydro-5-oxo-1,2,4-thiadiazol-3-yl.
The substituting position of R³ may be ortho, meta or para. Particularly preferred
is the ortho-position.
[0014] The heterocyclic residue (R³) may exist as tautomers. For example, there are three
tautomers a', b' and c' as in

where Z is O and g is O,

The heterocyclyl group of the formula

includes all of a', b' and c'.
[0015] Furthermore, R³ may be carboxyl, tetrazolyl, trifluoromethanesulfonamido(-NHSO₂CF₃),
phosphate, sulfo, cyano, lower(C₁₋₄)alkoxycarbonyl or the like. These groups may be
protected by lower alkyl groups which may be substituted or acyl groups, for instance.
All that is necessary is that R³ be a group chemically capable of forming or transformable
to an anion under biological or physiological conditions (e.g. by biotransformation
such as oxidation, reduction or hydrolysis by physiological enzymes).
[0016] R³ is preferably a tetrazolyl or carboxyl (more desirably tetrazoyl) group which
may be protected by a lower(C₁₋₄) alkyl group which may be substituted (e.g. methyl,
triphenylmethyl, methoxymethyl, ethoxymethyl, p-methoxybenzyl, p-nitrobenzyl, etc.)
or an acyl group (e.g. lower(C₂₋₅) alkanoyl, benzoyl, etc.). The substituting position
of R³ may be ortho, meta or para. Particularly preferred is the ortho-position.
[0017] X signifies that the adjacent phenylene and phenyl groups are coupled either directly
or indirectly through a spacer comprising a chain of not more than 2 spacer atoms
(preferably directly). This spacer may be any divalent chain whose linear moiety comprises
1 or 2 atoms and may be branched. Thus, lower(C₁₋₄) alkylene groups, -CO-, -O-, -S-,
-NH-, -CO-NH-, -O-CH₂-, -S-CH₂-, -CH=CH-, etc. can be mentioned.
[0018] Furthermore, n represents a whole number of 1 or 2 (preferably 1).
[0019] The structure formed by said R³, X and n

is preferably the following:

The following is a partial list of the representative nitrogen-containing heterocyclic
residues represented by the ring W.
[0020] In the following formulas, R¹ represents a hydrogen atom or a hydrocarbon residue
which may be substituted; Y represents a bond, -O-, S(O)
m- (where m is 0, 1 or 2) or -N(R⁴)- (where R⁴ is a hydrogen atom or an alkyl group
which may be substituted). Preferably, R¹ is a lower(C₁₋₅) alkyl (more preferably
a lower(C₁₋₄) alkyl) group which may be substituted by hydroxy, amino, halogen or
lower(C₁₋₄) alkoxy and Y is a bond, -O-, -S- or -N(R⁴)- (where R⁴ is hydrogen or lower(C₁₋₄)
alkyl).
[0021] Regarding the residue of formula (III)

wherein a and e constituting the heterocyclic residue independently represent 1 or
2 carbon or hetero atoms which may be substituted, d and f independently represent
one carbon or hetero atom which may be substituted, and b and c independently represent
one carbon or nitrogen atom which may be substituted, the following residues can be
mentioned.

wherein h represents -CH₂-, >=O, >=S, >S-(O)
m, -N(R⁴)- or -O-; m represents 0, 1 or 2; R⁴ represents hydrogen or an alkyl group
which may be substituted (preferably hydrogen or lower(C₁₋₄) alkyl).
[0022] Furthermore, as the residue of formula (IV):

(wherein a and b constituting the heterocyclic residue independently represent one
or two carbon or hetero atoms which may be substituted; c represents one carbon or
hetero atom which may be substituted), there can be mentioned the following:

wherein A represents an aromatic hydrocarbon residue optionally containing a hetero
atom or a heterocyclic residue, which may be substituted (preferably an aromatic hydrocarbon
residue such as phenyl); h and h' each represents -CH₂-, >=O, >=S, >S-(O)
m, -N(R⁴)- or -O-; m and R⁴ are as defined hereinbefore. It should be understood that
these structures are not exclusive but are merely illustrative.
[0023] The heterocyclic group of formula (III) may be substituted by a group represented
by R² (e.g. a group capable of forming or transformable to an anion) in addition to
the group Y-R¹. The preferred substituting position of R² is the position of the atom
indicated by f in the formula (III).
[0024] The group R² which is capable of forming or transformable to an anion includes, among
others, carboxyl which may be esterified or amidated, tetrazolyl, trifluoromethanesulfonamido(-NHSO₂CF₃),
phosphate, sulfonate, etc. and these groups may be respectively protected by a lower
alkyl group which may be substituted or an acyl group. Thus, it may be any group chemically
capable of forming or transformable to an anion under biological or physiological
conditions (e.g. by biotransformation such as oxidation, reduction or hydrolysis by
physiological enzymes).
[0025] The carboxyl group which may be esterified or amidated, as represented by R², includes,
among others, groups of the formula -CO-D, wherein D represents a hydroxyl group,
an amino group which may be substituted (e.g. amino, N-lower(C₁₋₄)alkylamino, N,N-dilower(C₁₋₄)alkylamino,
etc.) or an alkoxy group which may be substituted {lower(C₁₋₆) alkoxy groups whose
alkyl moieties may be substituted by hydroxyl, amino which may be substituted (e.g.
amino, dimethylamino, diethylamino, piperidino, morpholino, etc.), halogen, lower(C₁₋₆)
alkoxy, lower(C₁₋₆)alkylthio or dioxolenyl which may be substituted (e.g. 5-methyl-2-oxo-1,3-dioxolen-4-yl)
or a group of the formula -O-CH(R⁶)-OCOR⁵, wherein R⁶ represents hydrogen, a straight-chain
or branched lower(C₁₋₆) alkyl group (e.g.methyl, ethyl, n-propyl, isoproyl, n-butyl,
isobutyl, t-butyl, n-pentyl, isopentyl, neopentyl, etc.), a straight-chain or branched
lower(C₂₋₆) alkenyl group or a C₃₋₈ cycloalkyl group (e.g. cyclopentyl, cyclohexyl,
cycloheptyl, etc.); R⁵ is a straight-chain or branched lower(C₁₋₆) alkyl group (e.g.
methyl, ethyl, n-propyl, isopropyl, n-butyl, isobutyl, sec-butyl, t-butyl, n-pentyl,
isopentyl, neopentyl, etc.), a straight-chain or branched lower(C₂₋₆) alkenyl group,
a lower(C₁₋₃) alkyl group substituted by C₃₋₈ cycloalkyl (e.g. cyclopentyl, cyclohexyl,
cycloheptyl, etc.) or aryl (e.g. phenyl) which may be substituted (e.g. benzyl, p-chlorobenzyl,
phenethyl, cyclopentylmethyl, cyclohexylmethyl, etc.), a lower(C₂₋₃) alkenyl group
which may be substituted by C₃₋₈ cycloalkyl or aryl (e.g. phenyl) which may be substituted
(e.g. those containing such alkenyl groups as vinyl, propenyl, allyl, isopropenyl,
etc.; an example is cinnamyl), an aryl group, e.g. phenyl, which may be substituted
(e.g. phenyl, p-tolyl, naphthyl, etc.), a straight-chain or branched lower(C₁₋₆) alkoxy
group (e.g. methoxy, ethoxy, n-propoxy, isopropoxy, n-butoxy, isobutoxy, sec-butoxy,
t-butoxy, n-pentyloxy, isopentyloxy, neopentyloxy, etc.), a straight-chain or branched
lower(C₂₋₈)alkenyloxy group (e.g. allyloxy, isobutenyloxy, etc.), a C₃₋₈ cycloalkyloxy
group (e.g cyclopentyloxy, cyclohexyloxy, cycloheptyloxy, etc.), a C₁₋₃ lower alkoxy
group which may be substituted by C₃₋₈ cycloalkyl (e.g. cyclopentyl, cyclohexyl, cycloheptyl,
etc.) or aryl, e.g. phenyl, which may be substituted (e.g. those having such alkoxy
moieties as methoxy, ethoxy, n-propoxy, isopropoxy, etc.; e.g. benzyloxy, phenethyloxy,
cyclopentylmethoxy, cyclohexylmethoxy, etc.), a lower(C₂₋₃)alkenyloxy group substituted
by C₃₋₈ cycloalkyl (e.g. cyclopentyl, cyclohexyl, cycloheptyl, etc.) or aryl, e.g.
phenyl, which may be substituted (e.g. those groups which have such alkenyloxy moieties
as vinyloxy, propenyloxy, allyloxy, isopropenyloxy, etc.; e.g. cinnamyloxy) or an
aryloxy group such as phenyloxy which may be substituted (e.g. phenoxy, p-nitrophenoxy,
naphthoxy, etc.)}.
[0026] The substituent group R² may be a tetrazoyl, trifluoromethanesulfonamido, phosphate
or sulfonate group protected by a group capable of forming or transformable to an
anion [e.g. alkyl (e.g. lower(C₁₋₄) alkyl) or acyl (e.g. lower(C₂₋₅) alkanoyl, benzoyl
which may be substituted]. The substitutent group R² thus includes -COOH and its salt,
-COOMe, -COOEt, -COOt-Bu, -COOPr, pivaloyloxymethoxycarbonyl, 1-(cyclohexyloxycarbonyloxy)ethoxycarbonyl,
5-methyl-2-oxo-1,3-dioxolen-4-ylmethoxycarbonyl, acetoxymethoxycarbonyl, propionyloxymethoxycarbonyl,
n-butyroxymethoxycarbonyl, isobutyroxymethoxycarbonyl, 1-(ethoxycarbonyloxy)ethoxycarbonyl,
1-(acetoxy)ethoxycarbonyl, 1-(isobutyroxy)ethoxycarbonyl, cyclohexylcarbonyloxymethoxycarbonyl,
benzoyloxymethoxycarbonyl, cinnamyloxycarbonyl, cyclopentylcarbonyloxymethylcarbonyl
and so on. Moreover, R² may be any group that is chemically capable of forming an
anion or transformable to an anion (e.g. COO⁻ or a derivative thereof) under biological
or physiological conditions (e.g. biotransformation such as oxidation, reduction or
hydrolysis by physiological enzymes). R² may also be a carboxyl group or a prodrug
form thereof. R² may also be a group which is biologically or chemically transformed
into an anion in the living body, for instance.
[0027] The preferred group R² is a group of the formula - CO-D, wherein D represents a hydroxyl
group or a lower(C₁₋₄) alkoxy group the alkyl moiety of which may be substituted by
hydroxy, amino, halogen, lower(C₂₋₇)alkanoyloxy (e.g. acetoxy, pivaloyloxy, etc.),
lower(C₄₋₉)cycloalkanoyloxy, lower(C₁₋₆)alkoxycarbonyloxy (e.g. methoxycarbonyloxy,
ethoxycarbonyloxy, cyclohexyloxycarbonyloxy, etc.), lower(C₃₋₈)cycloalkoxycarbonyloxy,
lower(C₁₋₄)alkoxy or lower(C₃₋₈)cycloalkoxy.
[0028] The heterocyclic residue of formula (III) may have substituents in addition to the
groups represented by Y-R¹ and R², thus including halogen (e.g. F, Cl, Br, etc.),
cyano, nitro, lower(C₁₋₄) alkyl, lower(C₁₋₄) alkoxy, amino which may be substituted
(e.g. amino, N-(lower)(C₁₋₄)alkylamino (e.g. methylamino etc.), N,N-di(lower)(C₁₋₄)alkylamino
(e.g. dimethylamino etc.), N-arylamino (e.g. phenylamino etc.), alicyclic amino (e.g.
morpholino, piperidino, piperazino, N-phenylpiperazino etc.), a group of the formula
-CO-D', wherein D' represents a hydroxyl group or a lower(C₁₋₄) alkoxy group the alkyl
moiety of which may be substituted by hydroxy, lower(C₁₋₄) alkoxy, lower(C₂₋₆)alkanoyloxy
(e.g. acetoxy, pivaloyloxy, etc.) or lower(C₁₋₆)alkoxycarbonyloxy (e.g. methoxycarbonyloxy,
ethoxycarbonyloxy, cyclohexyloxycarbonyloxy, etc.), a tetrazolyl group which may be
protected by lower(C₁₋₄) alkyl or acyl (e.g. lower(C₂₋₅) alkanoyl, benzoyl which may
be substituted, etc.), trifluoromethanesulfonamido, a phosphoric acid group or a sulfonic
acid group. The preferred substituent are lower(C₁₋₄) alkyl and halogen. These substituents
may be situated in 1 or 2 optional substitutable positions of the cyclic structure.
[0029] The fused heterocycle of formula (III) preferably has the formula

wherein Y-R¹ and R² are as defined hereinbefore. Preferred are compounds having a
benzimidazole, thienoimidazole or imidazopyridine structure (benzimidazole and thienoimidazole,
in particular).
[0030] The above heterocyclic residue of formula (IV) may have further substituents in addition
to the group represented by Y-R¹, such as halogen (e.g. F, Cl, Br, etc.), cyano, nitro,
lower(C₁₋₄) alkyl which may be substituted, lower(C₁₋₄) alkoxy, amino which may be
substituted (e.g. amino, N-lower(C₁₋₄)alkylamino (e.g. methylamino etc.), N,N-di(lower)(C₁₋₄)alkylamino
(e.g. dimethylamino etc.), N-arylamino (e.g. phenylamino etc.), alicyclic amino (e.g.
morpholino, piperidino, piperazino, N-phenylpiperazine etc.), a group of the formula
-CO-D' [wherein D' represents a hydroxyl group or a lower(C₁₋₄) alkoxy group the alkyl
moiety of which may be substituted by hydroxy, lower(C₁₋₄) alkoxy, lower(C₂₋₆)alkanoyloxy
(e.g. acetoxy, pivaloyloxy, etc.) or lower(C₁₋₆)alkoxycarbonyloxy (e.g. methoxycarbonyloxy,
ethoxycarbonyloxy, cyclohexylcarbonyloxy, etc.)] or a tetrazolyl group which may be
protected by lower(C₁₋₄) alkyl or acyl (e.g. lower(C₂₋₅)alkanoyl, benzoyl which may
be substituted, etc.) trifluoromethanesulfonamido, a phosphoric acid group or a sulfonic
acid group. The preferred are lower(C₁₋₄) alkyl groups which may be substituted and
halogen atoms. These substituents may be concurrently situated in one or two optional
substitutable positions of the cyclic structure. The substituent for said lower(C₁₋₄)
alkyl which may be substituted includes hydroxy, carboxy and halogen.
[0031] The ring W includes a benzimidazole ring of the formula:

wherein the ring A represents a benzene ring optionally having one or more substituent
groups in addition to a group represented by R²; R¹ represents a hydrogen atom or
a hydrocarbon residue which may be substituted; R² represents a carboxyl group which
may be esterified; Y represents a bond, -O-, S(O)
m- (where m is 0, 1 or 2) or -N(R⁴)- (where R⁴ is hydrogen or an alkyl group which
may be substituted).
[0032] The compound of formula (I) includes compounds of the formula

,wherein the ring A represents a benzene ring optionally having substituents in addition
to the group R²; R¹ represents a hydrogen atom or a hydrocarbon residue which may
be substituted; R³ represents a group capable of forming or transformable to an anion;
X signifies that the phenylene group and phenyl group are joined to each other either
directly or through a spacer comprising a chain of not more than 2 spacer atoms; R²
represents a carboxyl group which may be esterified; y represents a bond, -O-, -S(O)
m- (where m represents 0, 1 or 2) or -N(R⁴)- (where R⁴ represents a hydrogen atom or
an alkyl group which may be substituted); n represents a whole number of 1 or 2, and
salts thereof and more specifically the benzimidazole-7-carboxylic acid compounds
and their derivatives described in Japanese published unexamined patent application
(Kokai Tokkyo Koho) No. 9373/1992, and 364171/1992, and EP 520423. Particularly preferred
are compounds of formula (I') which corresponds to the above formula (I) wherein R¹
represents a lower(C₁₋₅) alkyl group (preferably a lower(C₁₋₄) alkyl group) which
may be substituted by hydroxy, amino, halogen or lower(C₁₋₄) alkoxy; R² represents
a group of the formula -CO-D, wherein D represents a hydroxyl group or a lower(C₁₋₄)
alkoxy group the alkyl moiety of which may be substituted by hydroxy, amino, halogen,
lower(C₂₋₆)alkanoyloxy (e.g. acetoxy, pivaloyloxy, etc.), lower(C₁₋₆)alkoxycarbonyloxy
(e.g. methoxycarbonyloxy, ethoxycarbonyloxy, cyclohexyloxycarbonyloxy, etc.) or lower(C₁₋₄)
alkoxy J; the ring A represents a benzene ring which may be substituted, in addition
to group R², by halogen (e.g. F, Cl, Br, etc.), lower(C₁₋₄) alkyl, lower(C₁₋₄) alkoxy,
nitro, a group of the formula -CO-D', wherein D' represents a hydroxyl group or a
lower(C₁₋₄) alkoxy group the alkyl moiety of which may be substituted by hydroxy,
lower(C₁₋₄) alkoxy, lower(C₂₋₆)alkanoyloxy (e.g. acetoxy, pivaloyloxy, etc.) or lower(C₁₋₆)alkoxycarbonyloxy
(e.g. methoxycarbonyloxy, ethoxycarbonyloxy, cyclohexyloxycarbonyloxy, etc.), or an
amino group which may be substituted by lower(C₁₋₄) alkyl (preferably a benzene ring
substituted by lower(C₁₋₄) alkyl or halogen, and more preferably a benzene ring having
no substituent other than a group of the formula R²); y represents -N(R⁴)- [wherein
R⁴ represents hydrogen or lower(C₁₋₄) alkyl]; R³ represents a tetrazolyl or carboxyl
group (preferably tetrazolyl) which may be protected by a lower(C₁₋₄) alkyl group
which may also be substituted (e.g. methyl, triphenylmethyl, methoxymethyl, ethoxymethyl,
p-methoxybenzyl, P-nitrobenzyl, etc.) or an acyl group (e.g. lower(C₂₋₅)alkanoyl,
benzoyl, etc.); n represents 1; X represents a bond.
[0033] Angiotensin II antagonist compound used in the present invention include compounds
disclosed in the specifications of U.S. Patent No. 5,183,899, EP0425921A1, EP0430300A2,
EP0434038A1, EP0442473A1, EP0443568A1, EP0445811A2, EP0459136A1, EP0483683A2, EP0520423A2,
EP Application No. 93.114754.0 and EP application No. 93.120135.4.
[0034] As the preferred compounds for use as the active ingredient in the present invention
may be mentioned the compounds described in the examples of Japanese published unexamined
patent application (Kokai Tokkyo Koho) No. 364171/1992 or EP0459135A1 and EP 520423A2.
[0035] As compounds of formula (I) may be mentioned the compounds disclosed
inter alia in Japanese published unexamined patent application (Kokai Tokkyo Koho) No. 9373/1992,
Japanese published unexamined patent application (Kokai Tokkyo Koho) No. 364171/1992
and EP 520423 and these compounds can be produced by the processes described in the
same patent literature.
[0036] The compound of formula (I) which is used as the angiotensin II antagonist compound
in the present invention is low in toxicity and of value as a prophylactic/therapeutic
agent for viral diseases in animals, particularly mammalian animals (such as man,
dog, rabbit, mouse, rat, etc.).
[0037] The viral disease addressed by the present invention includes those diseases which
are caused or induced by pathogenic viruses belonging to either the category of DNA
viruses or the category of RNA viruses. Examples of such viruses are presented below.
- DNA viruses:
- Poxviruses, herpesviruses, adenoviruses, parvoviruses
- RNA viruses:
- Revoviruses, togaviruses, coronaviruses, rhabdoviruses, paramyxoviruses, orthomyxoviruses,
bunyaviruses, arenaviruses, retroviruses, picornaviruses, caliciviruses
The specific viral diseases include viral hepatitis (A, B, C, E), influenza, viral
pneumonia, viral bronchitis, herpetic infections (simplex virus, EB virus (infectious
mononucleosis), herpes zoster), poliomyelitis, AIDS (HIV infection), adult T-cell
leukemia (ATL), papilloma, measles, rubella, exanthema subitum, erythema infectiosum,
viral encephalitis, viral myelitis, cytomegalovirus infection, mumps, varicella, rabies,
viral enteritis, viral myocarditis, viral pericarditis and so on.
[0038] Among others, the present invention is preferably applicable for treatment or prevention
of diseases which are caused or induced by RNA viruses or hepatitis viruses. There
are particularly mentioned orthomyxoviruses or picornaviruses as RNA viruses. In addition,
there are particularly mentioned viral hepatitis (A, B, C, E), influenza, viral encephalitis,
viral enteritis, viral myocarditis or viral pericarditis among viral diseased described
above.
[0039] The compound of formula (I) or a salt thereof can be administered orally, parenterally,
by inhalation, intrarectally or topically. It can be used in the form of a pharmaceutical
composition or preparation (e.g. powders, granules, tablets, pills, capsules, injections,
syrups, emulsions, elixers, suspensions, solutions, etc.) containing at least one
species of the compound of the invention in combination with a pharmaceutically acceptable
carrier (such as adjuvants, excipients, ointment bases and/or diluents).
[0040] The composition or preparation for medical use can be manufactured by the conventional
procedures. As used in this specification, the term 'parenteral' or 'parenterally'
refers to any of the subcutaneous, intravenous, intramuscular, intraperitoneal, drip
and other routes or methods of administration. Injectable preparations, for example
sterile aqueous or oily suspensions for injection can be manufactured by the procedure
well established in the field using an appropriate dispersant or wetting agent and
a suspending agent. The sterile injectable preparations may also be sterile solutions
or suspensions in water, a nontoxic diluent, solvent or vehicle acceptable for purposes
of injection. As examples of said vehicle or solvent may be mentioned water, Ringer's
solution, isotonic saline and the like. Moreover, sterile nonvolatile oils can be
used as the solvent or suspension vehicle. For such purposes, virtually any type of
nonvolatile oil or fatty acid can be used. Thus, natural, synthetic and semisynthetic
fatty oils or fatty acids and natural, synthetic and semisynthetic mono-, di- or triglycerides
can be mentioned.
[0041] Suppositories for rectal administration can be manufactured using the active ingredient
and a suitable non-irritating base such as cocoa butter, polyethylene glycol and other
substances which are solid at room temperature but liquid at the rectal temperature
and, as such, would melt in the rectum to release the active ingredient.
[0042] The solid dosage form for oral administration includes the above-mentioned powders,
granules, tablets, pills, capsules and so on. To manufacture such a solid dosage form,
the active ingredient compound can be mixed with at least one additive such as sucrose,
lactose, cellulose and its derivatives, mannitol, maltitol, dextran, starch, agar,
aliginates, chitins, chitosans, pectin, gum tragacanth, gum arabic, gelatin, collagen,
casein, albumin, synthetic or semisynthetic polymers and glycerides. Such dosage forms
may, as usual, contain further additives, e.g. inert diluents, lubricants such as
magnesium stearate, preservatives such as parabens, sorbic acid, etc., antioxidants
such as ascorbic acid, α-tocopherol, cysteine, etc., disintegrators, binders, thickeners,
buffers, sweeteners, flavorants, perfumes and so on. Tablets and pills may be enteric-coated.
The liquid for oral administration includes medicinally acceptable emulsions, syrups,
elixirs, suspensions, solutions, etc. which may contain any inert diluent that is
routinely used in the field of art, such as water.
[0043] The dosage for any specific patient or individual is determined according to such
parameters as age, body weight, general physical condition, sex, diet, drip time,
therapeutic regimen, excretion rate, combination of plural drugs, current stage of
disease to be managed and so on.
[0044] The compound of general formula (I) or a salt thereof is low in toxicity and can
be used safely. The daily dose varies with the patient's condition and body weight,
species of compound, administration route, etc. but for administration as a therapeutic
drug for viral disease in an adult human, it is preferable that a daily oral dose
of 0.5 ∼ 20 mg or a daily intravenous dose of 0.5 ∼ 20 mg be administered in a single
dose or in 2 or 3 divided doses.
Effect of the Invention
[0045] Administration of an angiotensin II antagonist compound in accordance with the present
invention ameliorates virus-associated cell injuries, producing therapeutic effects
in viral diseases. It is also useful for the prevention of such diseases.
[0046] The following test example is intended to demonstrate the biological activity of
the angiotensin II antagonist compound and salt.
Test Example
Effect of angiotensin II antagonist compound in viral myocarditis
Compound 1: 1-(Cyclohexyloxycarbonyloxy)ethyl 2-ethoxy-1-[[2'-(1H-tetrazol-5-yl)biphenyl-4-yl]methyl]-1H-benzimidazole-7-carboxylate
Method:
[0047] Four-week-old DBA/2 mice were divided into 3 groups (n per group = 21) and intraperitoneally
inoculated with 10 pfu of encephalomyocarditis (EMC) virus. Starting 2 days after
inoculation, control 5% gum arabic solution (vehicle) (Group A), Compound 1, 0.3 mg/kg,
(Group A) and Compound 1, 3 mg/kg, (Group C) were respectively administered daily
until day 14. The survival rates in the respective groups on day 14 were compared
by the method of Kaplan-Mayer. In survivals, body weight (BW), heart weight (HW) and
heart/body weight ratio (HW/BW) were determined and the histopathological findings
of the heart were scored for each of the three parameters of myocardial cell necrosis,
cellular infiltration and calcification on the grading scale of 1 (<25%), 2 (25%≦,
<50%), 3 (50%≦, <75%) and 4 (75%≦). The above animal model of dilated cardiomyopathy
is described in Circulation, 65:1230-1235, 1982 or Circulation, 66:355-360, 1982.
[0048] The blood angiotensin II level was determined by radioimmunoassay. Intergroup comparison
was made by ANOVA test.
Results:
[0049] The survival rates on day 14 were 47.6% in Group A, 47.6% in Group B and 57.1% in
Group C. No significant difference was found.
[0050] The BW, HW and HW/BW data in survivals were as follows.
| Group |
BW (g) |
HW (mg) |
HW/BW (x 10³) |
| A (n=10) |
14.7±2.5 |
133±33 |
9.69±4.34 |
| B (n=10) |
14.2±2.1 |
139±28 |
10.14±3.30 |
| C (n=12) |
14.6±2.2 |
106±24* |
7.42±1.99 |
Pathological findings were as follows.
| Group |
Myocardial cell necrosis |
Cellular infiltration |
Calcification |
| A (n=10) |
2.3±1.2 |
2.6±1.3 |
2.1±1.1 |
| B (n=10) |
1.6±0.5 |
2.3±0.7 |
1.6±0.5 |
| C (n=12) |
1.1±0.3* |
1.4±0.7* |
1.1±0.3* |
[0051] Whereas the mean angiotensin II level in non-infected mice (n=5) was 32 pg/ml, that
in infected mice (n=6) was elevated to 73 pg/ml.
[0052] The above results indicate that, in viral myocarditis, the angiotensin II-receptor
antagonist alleviates myocardial damage and suppresses cardiac enlargement following
the acute stage.
Examples
[0053] The following examples are intended to describe the invention in further detail and
should by no means be construed as defining the scope of the invention.
Formulation Examples
[0054] Prophylactic/therapeutic dosage forms for viral diseases, each containing the angiotensin
II antagonist compound of the invention as an active ingredient, can be manufactured
according to the following exemplary formulations.
1. Capsules
[0055]
| (1) 2-Ethoxy-1-[[2'-(1H-tetrazol-5-yl)biphenyl-4-yl]methyl]benzimidazole-7-carboxylic
acid |
10 mg |
| (2) Lactose |
90 mg |
| (3) Microcrystalline cellulose |
70 mg |
| (4) Magnesium stearate |
10 mg |
| |
per capsule 180 mg |
[0056] (1), (2), (3) and one-half of (4) are blended and granulated. To the granulation
is added the remainder of (4) and the whole composition is sealed into gelatin capsule
shells.
2. Tablets
[0057]
| (1) 2-Ethoxy-1-[[2'-(1H-tetrazol-5-yl)biphenyl-4-yl]methyl]benzimidazole-7-carboxylic
acid |
10 mg |
| (2) Lactose |
35 mg |
| (3) Corn starch |
150 mg |
| (4) Microcrystalline cellulose |
30 mg |
| (5) Magnesium stearate |
5 mg |
| |
per tablet 230 mg |
[0058] (1), (2), (3), 2/3 of (4) and 1/2 of (5) are blended and granulated. To the granulation
are added the remainders of (4) and (5) and the whole composition is compression-molded
to provide tablets.
3. Injection
[0060]
| (1) Disodium 2-methylthio-1-[[2'-(1H-tetrazol-5-yl)biphenyl-4-yl]methyl]benzimidazole-7-carboxylate |
10 mg |
| (2) Inositol |
100 mg |
| (3) Benzyl alcohol |
20 mg |
| |
per ampule 130 mg |
[0061] (1), (2) and (3) are dissolved in sufficient distilled water for injection to make
2 ml and this solution is sealed into ampules. The whole procedure is carried out
under sterile conditions.
4. Capsules
[0062]
| (1) 1-(Cyclohexyloxycarbonyloxy)ethyl 2-ethoxy-1-[[2'-(1H-tetrazol-5-yl)biphenyl-4-yl]methyl]
benzimidazole-7-carboxylate |
10 mg |
| (2) Lactose |
90 mg |
| (3) Microcrystalline cellulose |
70 mg |
| (4) Magnesium stearate |
10 mg |
| |
per capsule 180 mg |
[0063] (1), (2), (3) and 1/2 of (4) are blended and granulated. To the granulation is added
the remainder of (4) and the whole composition is sealed into gelatin capsule shells.
5. Tablets
[0064]
| (1) 1-(Cyclohexyloxycarbonyloxy)ethyl 2-ethoxy-1-[[2'-(1H-tetrazol-5-yl)biphenyl-4-yl]methyl]
benzimidazole-7-carboxylate |
10 mg |
| (2) Lactose |
35 mg |
| (3) Corn starch |
150 mg |
| (4) Microcrystalline cellulose |
30 mg |
| (5) Magnesium stearate |
5 mg |
| |
per tablet 230 mg |
[0065] (1), (2), (3), 2/3 of (4) and 1/2 of (5) are blended and granulated. To the granulation
are added the remainders of (4) and (5) and the whole composition is compression-molded
into tablets.
6. Injection
[0067]
| (1) Disodium 2-ethoxy-1-[[2'-(1H-tetrazol-5-yl)biphenyl-4-yl]methyl]benzimidazole-7-carboxylate |
10 mg |
| (2) Inositol |
100 mg |
| (3) Benzyl alcohol |
20 mg |
| |
per ampule 130 mg |
[0068] (1), (2) and (3) are dissolved in sufficient distilled water for injection to make
2 ml and the solution is sealed into ampules. The whole process is carried out under
sterile conditions.